Pollybeak deformity in rhinoplasty: prevention and treatment.

OBJECTIVE: Patients with pollybeak deformity who underwent rhinoplasty were analyzed retrospectively and across centers to identify their primary risk factors, preventative measures, and treatment modalities. PATIENTS AND METHODS: The retrospective data of 100 pollybeak deformity cases (61 males and 39 females) were enrolled in our study. The causes leading to pollybeak deformity were evaluated and classified as (1) Over-resected bony dorsum, (2) Excessive supra tip scarring, and (3) Inefficient tip support causing an under-projected tip. The treatments applied to patients with pollybeak deformity were retrospectively evaluated and classified as (1) Triamcinolone acetonide injections (one or two injections), (2) Filler injection over the bony dorsum to balance, (3) Using a graft to achieve the desired nose shape, (4) Trimming down the excessive supra tip soft tissue and/or tip cartilage, and (5) Enforcing the tip support. RESULTS: Our results showed that the major cause of pollybeak deformity was excessive supra-tip scarring (48%). The other reasons are inefficient tip support, causing an under-projected tip (28%), and over-resected bony dorsum (24%). The modalities for the treatment of pollybeak deformity were (1) Trimming down the excessive supra tip soft tissue and/or tip cartilage (30%), (2) Triamcinolone acetonide injections (one or two injections) (28%), or (3) Enforcing the tip support (28%), (4) Using a graft to achieve the desired nose shape (14%) and (5) Filler injection over the bony dorsum to balance (6%). In some patients, more than one treatment modality was applied. Triamcinolone acetonide or filler injections were the non-surgical therapies for pollybeak deformities. CONCLUSIONS: We concluded that excessive supra-tip scarring is not directly related to a surgical error but rather depends on the patient and tissue healing. Care should be taken to avoid over-resecting the bony dorsum. Tip support should be provided to prevent inefficient tip support from causing an under-projected tip. However, efforts should be made to minimize supra-tip dead space and possibly proceeding pollybeak formation through proper bandaging.

Investigation of neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio and mean platelet volume in patients with tinnitus.

OBJECTIVE: This study aimed to evaluate patients with tinnitus in terms of mean platelet volume and platelet distribution width, and to explore neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio, recently reported in the literature as being possible inflammation markers. METHODS: This study comprised 64 tinnitus patients and 64 age-matched healthy controls. Statistical significance level was accepted as p < 0.05. RESULTS: Mean platelet volume (t = 3.245, p = 0.002) and platelet distribution width (Z = 3.945, p < 0.001) were significantly higher in the patient group than the control group. CONCLUSION: The results suggest that a prothrombotic condition might play a role in the pathophysiology of tinnitus.

The treatment of tongue haemangioma by plasma knife surgery.

A seven-year-old girl presented with a 4 cm x 2 cm lesion of the tongue which was located at the posterior one-third in the midline. The lesion was excised by plasma knife surgery. No complication, such as bleeding, shortness of breath or infection, occurred after the treatment. Plasma knife surgery is an acceptable choice for selected benign lingual vascular malformations.

Value of thallium-201 scintigraphy for primary tumour detection in patients with malignant neck masses.

The aim of this study was to assess the contribution of thallium-201 scintigraphy to primary tumour detection in patients with malignant neck masses and to evaluate its sensitivity and specificity. A total of 30 patients with histopathologically proven malignant tumours were included in the study. The sensitivity, specificity and accuracy of 201Tl scintigraphy were found to be 54%, 75% and 57% respectively. These results suggest that 201Tl scintigraphy has a limited value in the detection of the primary tumour in patients with malignant masses of the neck.

201Tl imaging for differentiating between malignant and benign neck masses.

The aim of this study was to assess the ability of 201Tl scintigraphy to differentiate between malignant and benign neck masses. Fifty-eight patients with neck masses, whose diagnoses were confirmed by histological examination, were examined. The sensitivity, specificity and accuracy of 201Tl scintigraphy were 80%, 96% and 88% respectively; when salivary gland masses were excluded, these values were 87%, 95% and 91% respectively. Our results suggest that 201Tl scintigraphy is highly reliable in determining the malignancy of neck masses, especially when salivary gland masses are excluded.

Bacteriology of antrum in children with chronic maxillary sinusitis.

Swabs from 93 chronically inflamed maxillary sinuses in children were taken from aerobic and anaerobic bacteria during endoscopy. Bacterial growth was present in 87/93 specimens (93%). Anaerobic bacteria were isolated in 81/87 culture-positive specimens (93%) and were recovered alone in 61 cases (70%) and mixed with aerobic or faculative bacteria in 20 (23%). Aerobic or facultative bacteria were present alone in six cases (7%). A total of 261 isolates (3/specimen), 19 (2.4/specimen) anaerobes and 69 (2.6/specimen) aerobes or facultatives, were isolated. The predominant anaerobic organisms were Bacteroides sp. and anaerobic cocci; the predominant aerobes or facultatives were Streptococcus sp. and Staphylococcus aureus. These findings indicate the important role of anaerobic organisms in chronic sinusitis.